Tonsillotome



Jan. 25, 1938. T MOORE 2,106,575

TONSILLOTOME Filed Feb) 1'7, 1936 fluhnTuuve v gwue/wbom w M P PatentedJan. 25, 1938 UNITED STATES PATENT OFFICE 5 Claims.

This invention relates to surgical instruments of the type used for theremoval of tonsils and it has for its primary objects the provision of asimple, inexpensive, and efiicient instrument consisting of a smallnumber of parts which are adapted for ready assembly for use, and whichare equally readily taken apart for cleaning and sterilization. Afurther object of the invention is the provision of an instrument inwhich an inexpensive blade of the order of a safety razor blade may beused while it is sharp and then be discarded, the low cost of the bladerendering its replacement less costly than the time required for itssharpening.

Other objects of the invention will appear in connection with thedescription of a preferred embodiment of the invention chosen forpurposes of illustration, though it will be evident that the inventiondoes not consist in the exact details of construction shown but thatmany modifications may be made within the scope of what is claimed.

In the drawing, Figure l is a side elevation with parts in sectionshowing the device with the cutting blade advanced to its forward limitof movement; Fig. 2 is a top plan view of the device with the blade inthe same position as in Fig. 1; Fig. 3 is a top plan View of the samedevice with the carrier retracted to hold the blade in its inoperativeposition ready for use; Fig. 4 is a bottom plan view of the carriermember; and Fig. 5 is a fragmentary elevation with parts in section onthe line V--V of Fig. 1, looking in the direction indicated by thearrows.

A handle member I has secured thereto at one end a guide member 2 whichis shown as having a socket 3 near one end to receive a projection 4 ofthe handle, a screw 5 holding the two members securely together forready separation.

A portion of the handle projects toward one side to serve as a fulcrumfor a lever 1 pivoted at 8 between its ends upon the handle portion 6and extending from the pivot to a point very close to the guide member2. A slot 9 formed in the lever near its end has a length greater thanits width to permit the introduction and withdrawal of the cross-bar IDof a T-shaped end piece formed on a blade carrier l I, the crossbarbeing of a length greater than the width of the slot, whereby when theend piece is introduced into the slot and turned at right angles orthrough any angle less than a half revolution, the ends of the cross-barwill engage the lever on each side of the slot if it is swung in adirection away from the sliding member I I, as is best shown in Fig. 5.

The blade carrier member H has .aflat surface for engagement with theguide member 2, and from this flat surface project two lugs, of whichthe lug l2 has its outer or top surface formed with ratchet teethdirected ,rearwardly, and the lug I3 is adapted for holding a cuttingblade. The ratchet lug l2 enters a slot M in the guide member 2, and theblade-holding lug l3 enters a slot [5 in the guide member. These slotsare of any suitable width, and their longitudinal axes will be parallelto permit longitudinal sliding movement of the carrier II, the end orends of one or both slots acting as stops to limit the extent of slidingmovement. Between the slots l4 and I5 is a slot I6 of greater lengththan width adapted for the passage of the crossbar portion ll of aspring I8 which may be formed by punching a T-shaped opening in the bodyof the spring, bending the stem portion IQ of the T at right angles tothe body of the spring and bending the cross-bar IT at right angles tothe stem or parallel to the spring body. Y The stem i9 is of a lengthsuch that when the cross-bar l'! is passed through the slot l6 andthrough the slot 20 formed in the carrier member II, which is oppositethe slot l6 when the'lugs l2 and I3 are in slots I4 and 15, the crossbar will lie outside of the lower surface of the carrier permitting thespring l8 to be swung lengthwise of the guide member 2, to bring theends of the cross-bar ll into engagement with the carrier on both sidesof the slot. The spring 3 has a hole near one end to engage a stud 2!set in the upper surface of the guide member 2 to prevent longitudinalor swinging movement of the spring. The slot 20 is long enough to allowthe carrier member II to slide through the entire extent of its travelwithout coming into contact with the stem IS. The spring I8 also has aportion struck up and bent forward to form a pawl portion 22 which isadapted to engage within the ratchet teeth on the lug l2, permitting theforward movement of the carrier member but preventing its return untilthe ratchhaving a cutting edge 26 on its roundedforward;

end, is provided with a slot 21 of a length less than that of the lug l3and only slightly longer than the distance from the inner end of thenotch 23 to the front wall of the shoulder 24. The blade is flexibleenough to permit it to bend down enough to enter the notch 23 when theslot is laid over the front end of the lug l3 and pressed downward. Whenthe front end of the slot is opposite the notch, the blade can be slidback- Ward into the notch, and the rear end of the slot will clear thetop of the lug to drop onto the shoulder 24, which will prevent theblade from sliding forward out of the notch until the rear end of themetal strip forming the blade is lifted above the top of the shoulder.The blade will be dull on all edges except the curved front edge whichwill lie substantially parallel with the upper surface of the guidemember, its bevel being suiiicient to prevent actual engagement of thecutting edge with the metal of the guide.

In Fig. 3, the blade is shown in its inoperative position with the bladecarrier retracted as indicated also in broken lines in Fig. 1. Just inadvance of the cutting edge of the blade, the guide member is formedwith an opening 28 of a size to admit the ordinary human tonsil, theforward curve of the opening and the front end of the guide member beingmade substantially concentric with the curvature of the cutting edge ofthe blade when in its extreme limit of forward movement. In slidingforward from the position shown in Fig. 3 to that shown in Fig. 2, thecutting edge will move parallel with the surface of the guide member 2completely across the opening 28. The front and sides of the opening 28are provided with a stepped rim 29 just out of contact with the cuttingedge and forming a guard therefor. A spring 30, secured to the handle I,engages the rear side of the lever l, tending to cause it to swingtoward the broken line position in Fig. 1 in which the blade carrier isretracted to the inoperative position shown in Fig. 3 with the cuttingedge beyond the rear edge of the opening 28.

With the blade and carrier in the inoperative position and with thelever l swung forward to the broken line position of Fig. l, theoperator can insert the instrument into the mouth of a patient and pressthe rim 29 around the tonsil until it extends for a desired distancethrough the opening 28. The lever 7 may then be pulled toward the solidline position of Fig. l, causing the blade carrier 1 I to slide forwardon the guide to move the blade 25 across the opening to slice offwhatever portion of the tonsil projects beyond the plane ofthe cuttingedge.

The front end of the blade carrier H is preferably made blunt with anundulating or notched edge as indicated at 30 in Fig. 4, and this bluntedge does not travel into contact with the rim 29 at the front edge ofthe opening 28, leaving a little space for a portion of the severedtissues to be squeezed between the carrier and the rim 29 be.- neath thecutting edge of the blade. The lower surface of the guide 2 opposite:the opening 28 is also preferably formed with a slight curve to leave aspace at 3! permitting the wavy edge of the carrier to grasp fibers ofthe part cutoff by the blade to hold it from dropping into the throat ofthe patient.

As the carrier moves forward, the pawl 22 rides up the inclined surfacesof the ratchet teeth on the lug l2, dropping down as each tooth passes,to prevent the spring 30 from retracting the blade carrier, thusautomatically holding the carrier in the position to which it has beenmoved, so that it will not release the severed tonsil portiondiagrammatically indicated at 32. The operator .can release the pawl atwill by lifting on the rolled end of the spring l8 to pull the pawl outof engagement with the ratchet tooth it is holding, whereupon the spring30 will swing the lever 'l to retract the carrier H to its rearwardlimit of movement.

It will be seen that the carrier is held slidably n the guide by tworesilient elements, the spring I8 and the blade 25, each of which canreadily be released and removed. The blade 25 has a relatively narrowrear portion in which the slot 21 is cut, and this can easily be liftedoff the shoulder to permit the blade to be slid forward out of the notch23. The blade may be kept for cleaning, sharpening, and sterilizing, ifdesired,

but its low cost obviates the necessity for such care, and it may bediscarded like a used safety razor blade. Extra blades would befurnished already carefully sharpened, sterilized, and protected inindividual holders ready for immediate use.

After removing the blade 25, the spring l8 may be disengaged from thestud 2| and the pawl 22 may also be lifted off the ratchet lug to freethe spring for movement crosswise of the guide to bring the cross-bar I!in alinement with the slots l6 and 20 through which the cross-bar mayreadily be removed. The carrier H is thus released from the guide andupon rotation through a quarter turn, the cross-bar can be withdrawnfrom the slot 9 to free it from the lever I. If desired, the screws 5and 8 may be removed to separate the guide from the handle and the leverfrom the, handle. Even the spring 30 may be removed by unscrewing thetwo screws that hold it on the handle. Thus every part is madeaccessible for thorough cleaning and sterilization and the reassembly isan easy and rapid task.

It will be evident to those skilled in the art that many changes insize, form, proportions, location of parts, and other details ofconstruction may be made without losing the advantages of the inventionordeparting from the principles as claimed.

I claim:

1. A surgical instrument comprising a guide member having anopeningformed therein and a slot extending therethrough, ablade-carrying:

member slidable upon said guide member and having a lug extendingthrough said slot, and a thin flexible blade slidably engaging the guideand engaging the lug under tension to hold the carrier member in slidingcontact with the guide member, the sliding movement of the carrier beingsuincient to carry the cutting edge of the blade across the opening inthe guide.

2. A surgical instrument comprisinga guide member, a blade-carryingmember adapted for sliding engagement with said guide member and havinga T-shaped projection at one end, an operating lever bearing againstsaid end of said carrier and having a slot near its end for the stemportion of the T-shaped projection, the cross-bar of the T-shapedprojection bearing against the rear side of the lever, the dimensions ofthe slot and the cross-bar being such that upon release of the carrierfrom the guide member permitting movement of the carrier to bring thecross bar into alinement with the slot, the carrier can be disconnectedfrom the lever.

3. A surgical instrument comprising a guide member having two slotsextending therethrough, a carrier member having two lugs, one of saidlugs having a, ratchet thereon and being adapted for sliding engagementwith one of said slots, the other lug being adapted for holding a knifeblade and for sliding engagement with the other of said slots, a pawlcarried by the guide member for engagement with the ratchet on said lugto restrain sliding movement of the carrier member in one direction, anda knife blade carried by said blade-holding lug.

4. A surgical instrument comprising a guide member having two slotsformed therein, a carrier member having two lugs, one having a ratchetformed thereon and slidably engaging one of said slots, the other ofsaid lugs extending through the other of said slots and beyond theopposite surface of said guide member, a blade formed with a cuttingedge and secured upon the said lug on the surface of the guide member,remote from the carrier member, and a securing member having a pawlportion adapted for engagement with the ratchet on said lug and havinganother portion engaging the carrier member to hold the lugs within theslots.

5. A device as in claim 4, in which the blade is flexible and engagesthe lug and the carrier member under tension to draw the carrier membertoward the guide member.

JOHN T. MOORE.

